Ya-Ching Lin is a resident of Arizona who has been on more than a dozen missions with MSF—South Sudan, Ethiopia, Democratic Republic of Congo, and India were among her more recent project locations. This spring and summer, she spent two-and-a-half months working as a project coordinator in Tissi, a region in southeastern Chad that is struggling to absorb an influx of people displaced by violence in the Darfur region of Sudan, just across the border.

A man and his family among other displaced families seeking shelter in Tissi, Chad.

Ya-Ching Lin is a resident of Arizona who has been on more than a dozen missions with MSF—South Sudan, Ethiopia, Democratic Republic of Congo, and India were among her more recent project locations. This spring and summer, she spent two-and-a-half months working as a project coordinator in Tissi, a region in southeastern Chad that is struggling to absorb an influx of people displaced by violence in the Darfur region of Sudan, just across the border.

This part of Chad was targeted by Chadian rebel groups and armed groups from Darfur between 2006 and 2010. Many Chadian villages were burned and looted. It was so bad that many Chadians fled to Darfur for safety. This year, many of these displaced Chadians have returned to Chad because of an upsurge in violence in Darfur. They make up about 40 percent of the displaced population—the remaining 60 percent are Sudanese refugees—and are particularly vulnerable. As they are not considered refugees in their own country, they have much more difficulty accessing humanitarian aid. For this reason, we try to target this group for most of our non-food item distributions. It’s hard to understand exactly what is happening in Darfur at the moment. From afar, it looks like multiple new inter-tribal conflicts, but when you look closer, it’s far more complex than that. Despite multiple rounds of peace talks, it doesn’t look like the violence will end anytime soon. Since the beginning of the year, we have seen the largest influxes of Sudanese refugees in Chad since 2005.

HARD TO REACH

Tissi is a really inaccessible area. The Bahr Azoum wadi, a very large seasonal river, fills up and cuts the region off from the rest of the country during the rainy season. It becomes almost an island. This happened a few weeks before I left. The MSF team has spent the last two months frantically trying to put project activities in place before the road access is cut off. Supplies too big or too heavy to fit in a small plane all had to be brought in before the rains started. We also split the team between Tissi and a new refugee camp where we’re working because we expect access between the two locations to be cut. Fortunately, the rains came a bit late this year so we had a few extra weeks to get the job done.

The MSF hospital in Tissi is one of the few solid buildings around. It was originally built to be a health center, but we have now transformed it into a small 35-bed hospital.

The health problems we see so far are pretty typical for a displaced population. There is a lack of clean water and sanitation. We see a lot of diarrhea, respiratory infections, and malnutrition in our outpatient consultations. We also see a lot of war-wounded patients. Twenty-four percent of our hospital admissions in the past two months are patients with violent injuries, which is quite high for an MSF project.

We have also set up a health post at the border with Sudan in a village called Um Doukhum. As the violence increases across the border, the Sudanese medical facilities are becoming less and less functional, and we’re starting to see more Sudanese patients come across for treatment.

WHAT IT’S LIKE

As for ourselves, we lived in large communal tents identical to those we use for overflow patients in our hospital. Our office and many of our warehouses are also in tents. We plan to replace these with more comfortable structures made out of grass, bamboo, and plastic sheeting once the rainy season starts and we have more time on our hands. This is the same local material that the refugees and returnees use to make their houses.

Security management is also a major concern, as this area was known for the many kidnappings, armed robberies, and car-jackings targeting NGOs in the past. At the moment, the whole
area is highly militarized.

This was my third MSF assignment in Chad, and I’ve worked in Darfur and Central African Republic, too. My interest and experiences in the area keeps drawing me back. The conflict goes on even though it’s no longer in the headlines these days.